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Support CBOs responding to increased referrals

  • MHSP Priority Area: Addressing Health Related Social Needs
  • Strengthen housing, food, and transportation access.
  • Recommendation: Explore and support existing policies and programs to improve housing and food security and access to transportation for pregnant and postpartum individuals and their families.
  • Actionable Strategies: Support CBOs responding to increased referrals
  • Lead: ACLAMO
  • Lead Web Site: https://aclamo.org/
  • Progress: In Progress

Data as of September 30, 2026: 42 new maternal enrollments

pdf Addressing Health Related Social Needs (HRSN) Actionable Strategies

ACLAMO will recieve $32,580 to provide care and expand their bilingual capacities to 120 pregnant and post-partum people in Montgomery County over 10 months. This care will help pregnant people progress toward health milestones.

Create a HRSN screen for pregnant and postpartum people

  • MHSP Priority Area: Addressing Health Related Social Needs
  • Strengthen housing, food, and transportation access.
  • Recommendation: Explore and support existing policies and programs to improve housing and food security and access to transportation for pregnant and postpartum individuals and their families.
  • Actionable Strategies: Create a HRSN screen for pregnant and postpartum people
  • Lead: Thomas Jefferson University
  • Lead Web Site: https://research.jefferson.edu/connected-care-center.html
  • Progress: In Progress

Data as of September 30, 2026: conducted literature scan, engaged 12 individuals with lived experience

pdf Addressing Health Related Social Needs (HRSN) Actionable Strategies

Thomas Jefferson University will receive $53,000 to review existing HRSN screening tools, collect feedback from pregnant and postpartum people on HRSN screening questions and processes, and disseminate findings and recommendations across Pennsylvania.

Create a Peer to Peer Learning Exchange for CBOs

  • MHSP Priority Area: Addressing Health Related Social Needs
  • Strengthen housing, food, and transportation access.
  • Recommendation: Explore and support existing policies and programs to improve housing and food security and access to transportation for pregnant and postpartum individuals and their families.  
  • Actionable Strategies: Create a Peer to Peer Learning Exchange for CBOs
  • Lead: CAAP and PACDV
  • Lead Web Site: https://www.thecaap.org/ https://www.pcadv.org/
  • Progress: In Progress

Data as of September 30, 2026: 18 attendees at kick-off for the peer-to-peer learning network exchange

Addressing Health Related Social Needs (HRSN) Actionable Strategies

The Community Action Association of Pennsylvania and the Pennsylvania Coalition Against Domestic Violence will collectively receive $122,000 to work in partnership to build a Peer Learning Network Toolkit designed to increase collaboration between community-based organizations, managed care organizations, and other maternal health stakeholders in Pennsylvania. They will then establish and facilitate the peer-to-peer exchange.

Create a Doula Apprenticeship Toolkit

  • MHSP Priority Area: Expanding and Diversifying the Maternal Health Workforce
  • Expand equitable maternal health apprenticeships.
  • Recommendation: Begin work to develop health care apprenticeship opportunities that focus on training underrepresented populations to expand the number of BIPOC midwives, doulas, community health workers, and home visitors to make maternal health care professions and paid training opportunities accessible.
  • Actionable Strategies: Create a Doula Apprenticeship Toolkit
  • Lead: PatientsRWaiting
  • Lead Web Site: https://www.patientsrwaiting.com/
  • Progress: In Progress

Data as of September 30, 2026: 1 toolkit developed for Black Maternal Health Week in March 2026

Expanding and Diversifying the Healthcare Workforce Actionable Strategies 

PatientsRWaiting will receive $50,000 to develop a doula apprenticeship toolkit to increase registered doula apprenticeship programs across Pennsylvania. Based in Lancaster, PatientsRWaiting founded the Diversifying Doulas Initiative which has been addressing the birthing needs of people of color since 2021. Building on their experience creating a doula apprenticeship program, they will investigate statewide barriers to and opportunities for creating an apprenticeship, including workforce development barriers and best practices, by engaging key stakeholders and conducting an environmental scan. Once created, the toolkit will be available to organizations interested in implementing a doula apprenticeship program.

Improving Education and Screening via an App or Website

  • MHSP Priority Area: Supporting Behavioral Health and Substance Use Disorder Needs
  • Improve postpartum mental health/SUD screening and timely referrals.
  • Recommendation: Develop a mechanism for universal postpartum depression screenings and faster mental health and SUD* referrals to support new mothers, which can also improve access to care and resources for women experiencing postpartum depression and improve integrated care programs and expanded mental health and SUD services.
  • Actionable Strategies: Improving Education and Screening via an App or Website
  • Lead: Materna Phia Health
  • Lead Web Site: https://www.phiahealth.com
  • Progress: In Progress

Data as of September 30, 2026: 475 total clients served, 72 behavioral health screens completed, 16 positive screens, 6 completed connection to referral

Behavioral Health and SUD Actionable Strategies Plan

Phia Health was awarded $150,000 to support a statewide initiative to deploy a behavioral health platform that supports pregnant and postpartum individuals across Pennsylvania. The platform provides evidence-based perinatal mental health screenings, continuous risk detection, and rapid escalation to licensed clinicians and care coordinators. Phia partners with OB practices, health systems, employers, and Medicaid MCOs to close critical care gaps and support families through the most vulnerable period of their lives. The initial phase of the initiative will focus on select urban and rural counties, with plans to go statewide. The Phia Health platform provides evidence-based perinatal mental health screenings with rapid escalation to licensed clinicians and care coordinators when needed. This approach proactively identifies behavioral health risks and ensures connection to treatment.

  1. Improve Access to Non-medical supports
  2. Improve Access to Non-medical supports
  3. Expanding the Role of Pharmacists in Maternity Care

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